Meniere's disease represents an idiopathic inner ear disorder characterized by endolymphatic hy-drops.Currently,the research methods for identifying genes associated with this disease mainly involve first-genera-tion sequencing and second-generation sequencing.This article reviews research on the genetic study of Meniere's disease,mainly summarizing the candidate genes with repeated pedigree validation in familial Meniere's disease,as well as those frequently reported in sporadic Meniere's disease.

Objective:To observe the effects of 4E (explore, express, explain, extend) teaching combined with Gibbs reflective cycle method on the thinking and learning ability of nurse interns in the Department of Burns and Plastic Surgery.Methods:A total of 96 nurse interns in the Department of Burns and Plastic Surgery between June 1, 2022 and September 1, 2023 were selected as the research objects. Based on internship period, they were divided into the control group (from June 2022 to January 2023, traditional teaching) and the observation group (from February 2023 to September 2023, 4E teaching combined with Gibbs reflective cycle method). The critical thinking ability and evidence-based medicine ability before and after the internship were compared, and the recognition of the teaching method was compared between the two groups. SPSS 20.0 was used for t test and χ2 test. Results:After the teaching, the critical thinking ability and evidence-based medicine ability of nurse interns in the two groups were significantly higher than those before the teaching. The scores of critical thinking ability and evidence-based medicine ability were significantly higher in the observation group compared to the control group. Compared with the control group, the observation group showed higher levels of recognition in terms of proactiveness (44/48 vs. 30/48), information access ability (45/48 vs. 32/48), emergency response ability (47/48 vs. 29/48), and enhancement of teacher-student relationships (46/48 vs. 30/48), and the differences were statistically significant ( P<0.05). Conclusions:The application of 4E teaching combined with Gibbs reflective cycle method in training nurse interns in the Department of Burns and Plastic Surgery can improve their critical thinking ability and evidence-based medicine ability, and the nurse interns have a high level of recognition for this teaching method.

Objective:To investigate the correlation between occupational ionizing radiation exposure and abnormal metabolic indicators, providing a basis for assessing the health risks of occupational ionizing radiation workers and establishing a risk prediction model for chronic metabolic diseases.Methods:In January 2023, 7708 individuals were randomly selected from the occupational health examination data in Zhejiang Province. After excluding 16 individuals due to record errors, 2698 on-the-job workers exposed to ionizing radiation from 2020 to 2021 were selected as the exposure group, 2027 pre-employment workers exposed to ionizing radiation from 2016 to 2022 were selected as the pre-employment control group, and 2967 non-ionizing radiation workers from 2016 to 2022 were selected as the control group. Demographic data, blood routine, urine routine, biochemical indicators, and peripheral blood lymphocyte micronucleus rate of each group were collected. One-way ANOVA and rank sum test were used for comparison of indicators. The exposure group was divided into different groups based on age, exposure duration, and body mass index (BMI), and the correlation between indicators and occupational ionizing radiation was analyzed. Lasso variable selection was conducted by constructing a penalty coefficient (λ), and a complete regression model was established.Results:There were statistically significant differences in indicators such as blood pressure, heart rate, and average hemoglobin concentration between the exposure group and the control group, as well as the pre-employment control group ( P<0.05). Through Lasso variable selection, 19 indicators including exposure length, systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, body mass index (BMI), urine pH value, red blood cell count, microscopic white blood cells, casts, absolute value of monocytes, mean corpuscular volume of red blood cells, mean hemoglobin concentration, alkaline phosphatase, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, and low-density lipoprotein cholesterol (LDL-C). There were statistically significant differences in exposure length, SBP, DBP, body weight, BMI, microscopic white blood cells, casts, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, LDL-C, and mean corpuscular volume of red blood cells among workers of different ages in the exposure group ( P<0.05) ; there were statistically significant differences in SBP, DBP, body weight, BMI, microscopic white blood cells, casts, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, LDL-C, and mean corpuscular volume of red blood cells among workers with different exposure durations ( P<0.05) ; there were statistically significant differences in exposure length, SBP, DBP, body weight, BMI, red blood cells, microscopic white blood cells, casts, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, LDL-C, absolute value of monocytes, mean corpuscular volume of red blood cells, and mean hemoglobin concentration among workers with different BMIs ( P<0.05) . Conclusion:Occupational ionizing radiation is associated with abnormal metabolic indicators such as blood pressure, heart rate, total bile acid, α-L-fucosidase, urea, and creatinine in the human body. More attention should be paid to the risk of chronic metabolic diseases among workers exposed to ionizing radiation.

To analyze the occurrence of early complications after total hip arthroplasty (THA) in patients with systemic lupus erythematosus (SLE).

Objective:To observe the effects of 4E (explore, express, explain, extend) teaching combined with Gibbs reflective cycle method on the thinking and learning ability of nurse interns in the Department of Burns and Plastic Surgery.Methods:A total of 96 nurse interns in the Department of Burns and Plastic Surgery between June 1, 2022 and September 1, 2023 were selected as the research objects. Based on internship period, they were divided into the control group (from June 2022 to January 2023, traditional teaching) and the observation group (from February 2023 to September 2023, 4E teaching combined with Gibbs reflective cycle method). The critical thinking ability and evidence-based medicine ability before and after the internship were compared, and the recognition of the teaching method was compared between the two groups. SPSS 20.0 was used for t test and χ2 test. Results:After the teaching, the critical thinking ability and evidence-based medicine ability of nurse interns in the two groups were significantly higher than those before the teaching. The scores of critical thinking ability and evidence-based medicine ability were significantly higher in the observation group compared to the control group. Compared with the control group, the observation group showed higher levels of recognition in terms of proactiveness (44/48 vs. 30/48), information access ability (45/48 vs. 32/48), emergency response ability (47/48 vs. 29/48), and enhancement of teacher-student relationships (46/48 vs. 30/48), and the differences were statistically significant ( P<0.05). Conclusions:The application of 4E teaching combined with Gibbs reflective cycle method in training nurse interns in the Department of Burns and Plastic Surgery can improve their critical thinking ability and evidence-based medicine ability, and the nurse interns have a high level of recognition for this teaching method.

Objective:To investigate the correlation between occupational ionizing radiation exposure and abnormal metabolic indicators, providing a basis for assessing the health risks of occupational ionizing radiation workers and establishing a risk prediction model for chronic metabolic diseases.Methods:In January 2023, 7708 individuals were randomly selected from the occupational health examination data in Zhejiang Province. After excluding 16 individuals due to record errors, 2698 on-the-job workers exposed to ionizing radiation from 2020 to 2021 were selected as the exposure group, 2027 pre-employment workers exposed to ionizing radiation from 2016 to 2022 were selected as the pre-employment control group, and 2967 non-ionizing radiation workers from 2016 to 2022 were selected as the control group. Demographic data, blood routine, urine routine, biochemical indicators, and peripheral blood lymphocyte micronucleus rate of each group were collected. One-way ANOVA and rank sum test were used for comparison of indicators. The exposure group was divided into different groups based on age, exposure duration, and body mass index (BMI), and the correlation between indicators and occupational ionizing radiation was analyzed. Lasso variable selection was conducted by constructing a penalty coefficient (λ), and a complete regression model was established.Results:There were statistically significant differences in indicators such as blood pressure, heart rate, and average hemoglobin concentration between the exposure group and the control group, as well as the pre-employment control group ( P<0.05). Through Lasso variable selection, 19 indicators including exposure length, systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, body mass index (BMI), urine pH value, red blood cell count, microscopic white blood cells, casts, absolute value of monocytes, mean corpuscular volume of red blood cells, mean hemoglobin concentration, alkaline phosphatase, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, and low-density lipoprotein cholesterol (LDL-C). There were statistically significant differences in exposure length, SBP, DBP, body weight, BMI, microscopic white blood cells, casts, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, LDL-C, and mean corpuscular volume of red blood cells among workers of different ages in the exposure group ( P<0.05) ; there were statistically significant differences in SBP, DBP, body weight, BMI, microscopic white blood cells, casts, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, LDL-C, and mean corpuscular volume of red blood cells among workers with different exposure durations ( P<0.05) ; there were statistically significant differences in exposure length, SBP, DBP, body weight, BMI, red blood cells, microscopic white blood cells, casts, albumin-to-globulin ratio, total bile acid, α-L-fucosidase, urea, creatinine, LDL-C, absolute value of monocytes, mean corpuscular volume of red blood cells, and mean hemoglobin concentration among workers with different BMIs ( P<0.05) . Conclusion:Occupational ionizing radiation is associated with abnormal metabolic indicators such as blood pressure, heart rate, total bile acid, α-L-fucosidase, urea, and creatinine in the human body. More attention should be paid to the risk of chronic metabolic diseases among workers exposed to ionizing radiation.

BACKGROUND: Knee osteoarthritis (OA) is still challenging to prevent or treat. Enhanced endoplasmic reticulum (ER) stress and increased pyroptosis in chondrocytes may be responsible for cartilage degeneration. This study aims to investigate the effect of ER stress on chondrocyte pyroptosis and the upstream regulatory mechanisms, which have rarely been reported. METHODS: The expression of the histone methyltransferase enhancer of zeste homolog 2 (EZH2), microRNA-142-3p (miR-142-3p), and high mobility group box 1 (HMGB1) and the levels of ER stress, pyroptosis, and metabolic markers in normal and OA chondrocytes were investigated by western blotting, quantitative polymerase chain reaction, immunohistochemistry, fluorescence in situ hybridization, fluorescein amidite-tyrosine-valine-alanine-aspartic acid-fluoromethyl ketone (FAM-YVAD-FMK)/Hoechst 33342/propidium iodide (PI) staining, lactate dehydrogenase (LDH) release assays, and cell viability assessments. The effects of EZH2, miR-142-3p, and HMGB1 on ER stress and pyroptosis and the hierarchical regulatory relationship between them were analyzed by chromatin immunoprecipitation, luciferase reporters, gain/loss-of-function assays, and rescue assays in interleukin (IL)-1β-induced OA chondrocytes. The mechanistic contribution of EZH2, miR-142-3p, and HMGB1 to chondrocyte ER stress and pyroptosis and therapeutic prospects were validated radiologically, histologically, and immunohistochemically in surgically induced OA rats. RESULTS: Increased EZH2 and HMGB1, decreased miR-142-3p, enhanced ER stress, and activated pyroptosis in chondrocytes were associated with OA occurrence and progression. EZH2 and HMGB1 exacerbated and miR-142-3p alleviated ER stress and pyroptosis in OA chondrocytes. EZH2 transcriptionally silenced miR-142-3p via H3K27 trimethylation, and miR-142-3p posttranscriptionally silenced HMGB1 by targeting the 3'-UTR of the HMGB1 gene. Moreover, ER stress mediated the effects of EZH2, miR-142-3p, and HMGB1 on chondrocyte pyroptosis. In vivo experiments mechanistically validated the hierarchical regulatory relationship between EZH2, miR-142-3p, and HMGB1 and their effects on chondrocyte ER stress and pyroptosis. CONCLUSIONS A novel EZH2/miR-142-3p/HMGB1 axis mediates chondrocyte pyroptosis and cartilage degeneration by regulating ER stress in OA, contributing novel mechanistic insights into OA pathogenesis and providing potential targets for future therapeutic research.
Enhancer of Zeste Homolog 2 Protein/genetics* ; Osteoarthritis, Knee/pathology* ; Chondrocytes/metabolism* ; Pyroptosis/physiology* ; HMGB1 Protein/genetics* ; MicroRNAs/metabolism* ; Endoplasmic Reticulum Stress/genetics* ; Humans ; Animals ; Rats ; Male ; Rats, Sprague-Dawley ; Middle Aged

Meniere's disease represents an idiopathic inner ear disorder characterized by endolymphatic hy-drops.Currently,the research methods for identifying genes associated with this disease mainly involve first-genera-tion sequencing and second-generation sequencing.This article reviews research on the genetic study of Meniere's disease,mainly summarizing the candidate genes with repeated pedigree validation in familial Meniere's disease,as well as those frequently reported in sporadic Meniere's disease.

Objective:To investigate the clinical effect of intraarticular vancomycin on early periprosthetic joint infection (PJI) in knee arthroplasty and the incidence of postoperative complications.Methods:This is a retrospective cohort study. The clinical data of 1 867 patients who underwent primary knee arthroplasty at Department of Joint Surgery, the Affiliated Hospital of Qingdao University from April 2022 to June 2023 were retrospectively analysed, including total knee arthroplasty (TKA), robotic-assisted total knee arthroplasty (RA-TKA) and unicondylar knee arthroplasty (UKA). There were 687 males and 1 180 females, aged (68.0±11.2)years(range:45 to 87 years). Patients were divided into the vancomycin group and the control group according to whether or not intra-articular injection of 1 g of vancomycin powder dissolved in 30 ml of saline was performed after intraoperative joint capsule closure. In the vancomycin group, 925 patients were included, including 782 TKA, 27 RA-TKA and 116 UKA.In the control group, 942 patients were included, including 767 TKA, 99 RA-TKA and 76 UKA. Early PJI, wound complications, and vancomycin-related toxicity including acute renal collapse, ototoxicity, and allergic reactions were assessed within 3 months postoperatively. The data were compared using the independent sample t test, χ2 test, and Fisher's exact probability method, as appropriate. Major Extremity Trauma Research Consortium (METRC). Results:No PJI was found in all patients in the vancomycin group.Five cases (0.7%,5/767) of early PJI were found in TKA patients in the control group, with a statistically significant difference ( P=0.030); 1 case of early PJI was found in each RA-TKA and UKA patients, with non-significant difference compared with vancomycin group (all P>0.05). Two cases (0.3%,2/782) of incisional complications were found in TKA patients in the vancomycin group, and 4 cases (0.5%, 4/767) of incisional complications were found in TKA patients in the control group, with non-significant difference( P=0.449); no incisional complication was found in RA-TKA patients in the vancomycin group, and 1 case (1.0%,1/99) of incisional complications were found in RA-TKA patients in the control group, the difference was not statistically significant ( P>0.05); no incisional complication was found in both groups of UKA patients.No vancomycin-related acute kidney injury, ototoxicity, or allergic reactions was observed in all patients. Conclusion:Intra-articular injection of 1 g of vancomycin suspension after arthrotomy closure during TKA maybe lower the risk of early PJI without increasing the risk of wound complication and vancomycin-associated systemic toxicity.

Objective To develop and evaluate a fine-tuned large language model(LLM)for traditional Chinese medicine(TCM)prescription recommendation named TCMLLM-PR.Methods First,we constructed an instruction-tuning dataset containing 68 654 samples(ap-proximately 10 million tokens)by integrating data from eight sources,including four TCM textbooks,Pharmacopoeia of the People's Republic of China 2020(CHP),Chinese Medicine Clinical Cases(CMCC),and hospital clinical records covering lung disease,liver disease,stroke,diabetes,and splenic-stomach disease.Then,we trained TCMLLM-PR using Chat-GLM-6B with P-Tuning v2 technology.The evaluation consisted of three aspects:(i)compari-son with traditional prescription recommendation models(PTM,TCMPR,and PresRecST);(ii)comparison with TCM-specific LLMs(ShenNong,Huatuo,and HuatuoGPT)and general-domain ChatGPT;(iii)assessment of model migration capability across different disease datasets.We employed precision,recall,and F1 score as evaluation metrics.Results The experiments showed that TCMLLM-PR significantly outperformed baseline models on TCM textbooks and CHP datasets,with F1@10 improvements of 31.80%and 59.48%,respectively.In cross-dataset validation,the model performed best when migrating from TCM textbooks to liver disease dataset,achieving an F1@10 of 0.155 1.Analysis of real-world cases demonstrated that TCMLLM-PR's prescription recommendations most closely matched actual doctors'prescriptions.Conclusion This study integrated LLMs into TCM prescription recommendations,leverag-ing a tailored instruction-tuning dataset and developing TCMLLM-PR.This study will pub-licly release the best model parameters of TCMLLM-PR to promote the development of the decision-making process in TCM practices(https://github.com/2020MEAI/TCMLLM).